Podcast 39 – Omega 3 & Fish Oil

Transcription

Dr. Chad Edwards: This is Dr. Chad Edwards and you are listening to podcast 39 of Against the Grain. Are you tired and fatigued? Are you frustrated with doctors because they just don’t seem to listen? Do you want to fix your pain without surgery? If you answered ‘yes’ to any of these questions, then we are the clinic for you. We offer Tulsa prolotherapy, PRP or platelet-rich plasma therapy and stem cell injections, IV nutritional therapies, bioidentical hormone replacement therapy, and functional medicine to get you back on track to optimal health. Call our clinic at 918-935-3636 or visit our website at www.revolutionhealth.org to schedule your appointment today.
Speaker: Welcome to Against the Grain podcast with Dr. Chad Edwards where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to a healthy lifestyle. Get ready because we’re about to go against the grain.
Marshall: What up, this is the super tall Marshall Morris, joined today by Dr. Chad Edwards who believes that 80% of medical recommendations are crap. That’s technically speaking, Dr. Edwards. He is the author of Revolutionize Your Health with Customized Supplements, served in the U.S. Army for 23 years. He is a board certified family physician and, most importantly, he is the founder of www.revolutionhealth.org and the Against The Grain podcast. Dr. Edwards, how are you today?
Dr. Edwards: I’m good. I’m ready to talk about this topic.
Marshall: Okay, great stuff. You prepped me on it. This is another one of those I don’t know anything about but I’m just irrationally excited about it. What are we talking about today?
Dr. Edwards: We’re talking about fish oil for Omega 3s.
Marshall: Fish oil or Omega 3s? Are they one and the same? I’ve heard both but-
Dr. Edwards: Yes, most of the time when we’re talking about fish oil and we’re talking about Omega 3s, you can basically use them synonymously, but we’re going to get into why I’m being a little bit hesitant on saying that. It’s important to understand what does Omega 3 mean. Hopefully, I won’t get too geeked out on this, but basically you have these long chain fatty acids. You’ve heard of triglycerides. Triglycerides are fats and each one of those– ‘tri’ means three, and ‘glyceride’ means the glycerol backbone triglycerides. You have these fatty acids attached to a glycerol backbone. Those fatty acids are hydrocarbons. You get a carbon and hydrogen and then sometimes you have a double bond in there. When you have a double bond, it’s called an unsaturated fat because it’s not saturated with the hydrogens.
You have mono- and poly- unsaturated fats and Omega 3s are poly-unsaturated fatty acids. Means they’ve got these double bonds in them and it changes the behavior of these fats. They’re good healthy fats. The Omega portion refers to the location of that double bond or at least of the first double bond. The alpha carbon, when you look at these chains, you’ve got the backbone of carbon, and the first one on that glycerol backbone is called the Alpha carbon and on the far end at the tail, so to speak, that’s called the Omega carbon. When we count backwards, you count the Omega carbon and then you count–so one, two, three and where the third one is, that’s where the double bond is going to be. If you have a double bond at the sixth carbon from the end, that’s called an Omega 6.
Omega 9 would be nine carbons from the end. Omega 3s are referred to this broad category of fats where the double bond is three carbons away from the end. They’ve got certain characteristics associated with them. That’s what Omega 3s refer to and then, of course, fish oil is a good source of Omega 3, but there are other things in fish oil, so that’s why I’m a little reluctant to say, “Yes, the two are synonymous.”
Marshall: Most people, they will take fish oil as a good source of Omega 3s?
Dr. Edwards: That’s correct.
Marshall: Okay. But then also contained in fish oil are maybe some other things as well?
Dr. Edwards: Yes, exactly.
Marshall: Okay, cool. Let’s get into this. Why is this a controversial topic? Why is this against the grain?
Dr. Edwards: I don’t know if taking Omega3s is against the grain, but the way we often do it is very poorly educated even among physicians. I would argue that most people at least that I talk to don’t really know what they’re doing when it comes to supplementing with an Omega 3. What does it mean? Why are you taking it? Are you taking a good one? That’s really the ultimate piece and I want to get in a little bit of why.
Marshall: A lot of my friends take Omega 3 because the–‘My friends take Omega3’.
Dr. Edwards: Yes. Exactly. It’s a good idea. “You’re not taking Omega 3? You’ve got to take Omega3.”
Marshall: Get into maybe some of the reasons why it is good Tulsa prolotherapy.
Dr. Edwards: Yes. Omega 3 is–first of all, there’s a test that we do in my clinic called the Omega3 index. The test has been around for a little while. It’s been very well validated and shown that patients with an Omega 3 index, that’s the percentage of these fatty acids on the surface of red blood cells, called the Omega 3 index. When that is greater than 8%, it corresponds to a 90% reduction in sudden cardiac death compared with someone with an Omega 3 index of 4%. That means your heart just stops. Usually that would be associated with like a heart attack or something like that, but much more likely for your heart to stop– sudden cardiac death, if you have lower levels of Omega 3s. The other piece of this is there’s a pathway and I won’t get too geeked out on this.
It wouldn’t make sense until you see it anyway, but called the arachidonic acid pathway and we’ve talked about this a little bit when we’ve talked about Tulsa prolotherapy and making inflammatory chemicals. Many people will talk about how our diet is so pro-inflammatory and they’ll talk about how Omega 3s are anti-inflammatory. It’s because of this arachidonic acid pathway and that’s where– arachidonic acid is an Omega 6 fatty acid and it’s named for that, but there are a number of enzymes that these fatty acids go through, and it produces certain chemicals and the Omega 3s can go through it, the Omega 6s can go through it. When we don’t have a good balance in our fats, we make too many pro-inflammatory chemicals.
When we eat better levels of Omega 3s, we tend to offset that just a little bit because the product, the inflammatory chemicals that are made within Omega 3, are much less inflammatory. Relatively anti-inflammatory, so it’s important to get a good balance of those fats.
Marshall: Okay, you need not too much of it, you still need to monitor it as many of the things that we talk about on this podcast. How many people may be doing it wrong or taking it wrong, dosing it wrong? Explain that to me.
Dr. Edwards: First of all, they’ll think, “Okay, I just need to go take a fish oil.” Then they’ll go down to Wal-Mart or Costco, or wherever there are local pharmacy and they’ll just grab the fish oil off the shelf. There’s a few problems with that. Number one is, how much are you actually getting? When we’re talking about Omega 3s and the benefit, we’re talking about two specific long chain fatty acids, two of these Omega 3 long chain fatty acids, and specifically E.P.A. and D.H.A. Those are the two that we’re looking for. E.P.A. is the 20 carbon long version and D.H.A is the 22 carbon long version. Fish oil is a good source of those two. We’re looking specifically for the E.P.A. and D.H.A. I was in my parents’ house one day and I had them– they were taking fish oil because I had been harassing them. “You guys got to take your fish-oil.”
They went and they got one that they had at Wal-Mart. I looked at the back of the bottle– the front of the bottle says “Fish oil, 1,000 milligrams”. I think underneath it, it says “300 milligrams total Omega3s.” That’s part of the distinction. 1,000 milligrams of fish oil, but 300 milligrams total Omega 3s. When you look at the label and try and figure out, “Okay, how much am I actually getting of this E.P.A and D.H.A?” I took a picture of the back of the label and I’ve got it in front of me here. There’s a total of one gram of fat because that’s what it says on the front – “1000 milligrams to one gram”. Saturated fat was 0.5 grams. Half of what was in this pill was saturated fat. Now I would argue the saturated fat is not the devil, but that’s another podcast.
Then when you go down here and look at it, it says “natural fish oil concentrate, 1,000milligrams” and then it says “total Omega 3 fatty acids with E.P.A. and D.H.A 300 milligrams.” Now my problem with this is there’s a couple of things. I generally recommend two to three grams of Omega 3s per day. That means two to three grams of E.P.A. and D.H.A. This thing says a 1,000 milligrams, so you’d think, “I just have to take two of those.” The reality is, you need to take like six to 12 of these per day in order to get the right dose of the right thing. The second thing is the way this is labeled is misleading. It says “total Omega 3 fatty acids” and in parentheses it says “with E.P.A. and D.H.A.”
Is that 300 milligrams of E.P.A and D.H.A? It’s not clear. It could be 20 milligrams of E.P.A and D.H.A and 280 milligrams of some other Omega 3.
Marshall: Sure.
Dr. Edwards: Now, that brings up another point, and that’s another Omega 3 that’s really common, and it’s the plant form of Omega 3 called A.L.A. A.L.A we find in flaxseed oil and those kinds of things, walnuts, and those kinds of things. The problem with A.L.A– it’s not bad, it’s not a problem, but it has to be converted. Your body does not use A.L.A other than to convert it to E.P.A and D.H.A. A.L.A is actually considered an essential fatty acid because you can’t synthesize the A.L.A, but you can make E.P.A and D.H.A from A.L.A. Even though you don’t use it, it’s still considered an essential fatty acid. The problem is the conversion process of A.L.A to E.P.A and D.H.A. A.L.A is the 18-carbon version, is inefficient in a lot of people. We just don’t get the levels of what we really need by taking good amounts of A.L.A. I always recommend the E.P.A, D.H.A.
Marshall: Just like the hormones and the supplements, the quality of the fish oil that you’re taking is super important.
Dr. Edwards: Absolutely Tulsa prolotherapy.
Marshall: Okay. And there is varying degrees of quality of fish oil?
Dr. Edwards: Oh, boy. We’ve talked about the numbers and how much, all those kinds of things. When we come back, let’s talk about the quality of the fatty acid itself and what are you getting.
Marshall: Okay, cool.
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Marshall: Okay, we are back and we are talking about fish oil, and the Omega 3 contained within fish oil. Let’s get into a little bit of the quality and the things that contribute to the quality of this fish oil.
Dr. Edwards: Yes. Obviously when you take a fish oil you want to make sure that it has the right quantities of the right things. But then, how much good stuff are you getting? We talked about the fact that these are poly-unsaturated fats. That means there’s double bonds and those kinds of things. Those structures are subject to what we call oxidation. And oxidation is where oxygen comes in, adds electrons and it changes that chemical, and it’s almost like rust sort of. It kind of rusts away at these fatty acids and it kind of breaks them down, and that process just happens over time.
There are things that we can do to help protect those fats. One of the things that we can do is use vitamin E, and there are definitely others that can help protect those Omega 3s, to keep them from being degraded. But when you’re taking a fish oil, if it’s been sitting on the shelf for a long time, if it’s got a long shelf life, much higher risk that you’re taking an oxidized Omega 3. Those oxidized Omega 3s are probably more harmful than beneficial. So now you’re taking something thinking that you’re being beneficial, and it may actually be detrimental. If you open up your bottle of fish oil and it smells rancid or it smells really strong fish, throw it away. It is rancid and you don’t want to use it.
Marshall: It’s not just a by-product of taking fish oil Tulsa prolotherapy.
Dr. Edwards: That’s correct.
Marshall: Okay.
Dr. Edwards: Yes, that’s exactly right. You don’t want these things to be oxidized and damaged. Another thing is – these are coming from fish. The fish fixate nit– not nitrogen, mercury in the water. And the higher up the food chain, so to speak, the more that mercury gets concentrated and so poor quality fish oils may contain higher levels of toxins like mercury. We want to make sure that it’s processed appropriately and that we don’t have high levels of mercury in our stuff. The fish oil that I recommend, that we sell at our clinic, passes California’s– I forget the name, it’s in the book where I talk about California’s stringent requirements, and anything that contains a toxin or something like that has to– there’s like really strict regulations on that stuff. Ours passes all of those things.
There’s a very interesting website that you can go to. The site is called IFOS, I-F-O-S, and it’s the International Fish Oil Society or something like that. And they actually independently third-party test fish oils and they’ll look at a number of different– we’ll talk more about each of those components on another podcast, but they actually measure the amounts of oxidative damage and stress and how much stuff is there in there to protect that. If you’re taking a fish oil and you want to know the quality of it, you can go to that website and it’ll tell you. The other thing that it’ll tell you is what lot number did they test. Many supplement companies do not test every lot. The supplement company that I recommend, Xymogen, does test every lot, number one. And number two, they had exceedingly high levels of the good stuff and low levels of the bad stuff. Go do a head-to-head comparison, I mean challenge them. It’s really, really good stuff. You want to make sure that you get the right amount of stuff and you want to make sure that you get good quality of stuff. And then protect it from light, keep in a cool environment, those kinds of things.
Marshall: Okay, Omega 3. Got to take the right amount, you got to make sure that you get in the right amount of the good stuff, you got to make sure that it’s not sitting on your shelf. Is there an average– how long a bottle of fish oil could sit on your shelf? Is there a specific amount of time or something for listeners to take home with them?
Dr. Edwards: Most of the time, what I’ve seen, is they try to keep a shelf life of two years or less. If you got something that says a “six year shelf life” it’s like, “Okay, what did you put in there to make it work that stable that long?” But a lot of it depends on the quality of the supplement to begin with, and what did you put as an antioxidant to keep it safe in there. And it’s one of those things that, when you get a really high quality supplement company, they’re looking at all of these components, but a lot of the cheap stuff they’re not doing that. It’s not cost effective for them to do that. There’s some little subtle nuances, and again it’s addressed to the IFOS website– how much protective stuff is in there? If I’m really trying to save money, then I’m not going to do all that other stuff, I just get the cheap stuff and it’s got the fish oil in it, but it may not have the same level of quality and nobody’s looking.
Marshall: How do I know if I need to take fish oil?
Dr. Edwards: Number one, we do the Omega 3 index in my clinic. We want that above 8%. Number two, if you couldn’t come to the clinic or you can’t get tested, then just about everyone would benefit from it. If you had a perfect diet, you wouldn’t really need to worry about it. But it’s almost never that I see that. I literally have two patients in my practice, two that are able to get an optimal level of Omega 3s just from diet. But if you have a diet high in wild caught fish, some of the farm raised stuff, it all depends on what those fish are eating. And if they’re eating cheap pellets and things like that, they’re not going to have the same levels of Omega 3s. The wild caught stuff tends to have higher levels of that Tulsa prolotherapy.
Marshall: Yes, that’s what I was going to say. Those two patients are eating salmon all the time.
Dr. Edwards: Exactly, exactly.
Marshall: Then, once you start taking Omega 3 fish oil, it’s an everyday thing? Or it’s every couple days? Or how frequently, once you have determined, “Yes, I do need some more Omega 3 in my diet.” How frequent?
Dr. Edwards: Mmany of the fat soluble vitamins, you can even take once a week. I would argue that you could probably space it out, it doesn’t necessarily need to be an everyday thing. But as a supplement, I recommend it every day.
Marshall: Cool. What am I missing about fish oil? I feel like I’ve learned so much about fish, fish oil, Omega 3, and triglycerides on this podcast.
Dr. Edwards: It’s really good for inflammation, it’s really good for your overall health, it’s really good for the cell function and communication from cells, one to another. It’s important for overall health, it’s an effective thing to take as a supplement. Patients tend to do better, get anti-inflammatory, lots of good benefits to it, and it’s not really expensive. Ours is about a dollar a day, depending on your dose.
Marshall: Cool. Thank you so much, Dr. Chad Edwards.
Dr. Edwards: Happy fish oil.
Marshall: Happy fish oil.
Speaker: Thanks for listening to this week’s podcast with Dr. Chad Edwards. Tune in next week, where we’ll be going against the grain.
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